The primary effect is out of the conception of the psychology, which emphasizes the importance of the initial stimuli. Although the primary effect of acupuncture and moxibustion happens and is applied constantly in clinic, the conception, connotation and application of it had not been explained definitely yet. The writers attempt to explain the characteristics, theoretic significance and clinical values of the clinical primary, effect of acupuncture and moxibustion based on the conception of it so as to provide a certain of reference to the study on the clinical primary effect of acupuncture and moxibustion.
Acupuncture Therapy ; psychology ; Humans ; Moxibustion ; psychology ; Treatment Outcome

Bone and Bones ; blood supply ; Tissue Engineering

Objective To compare the curative effect of several surgical treatments for closed urethral injury.Methods A retrospective study was done on 200 cases of closed urethral injury treated with various methods from June 2002 to June 2012,including 44 cases of anterior urethral injury treated with endoscopic transurethral realignment (anterior endoscopic group),32 cases of anterior urethral injury with transperineal urethral repair (repair group),42 cases of posterior urethral injury with transperineal urethral termino-terminal anastomosis (anastomosis group),35 cases of posterior urethral injury with endoscopic transurethral realignment (posterior endoscopic group),and 47 cases of posterior urethral injury with endoscopic transurethral and transvesical realignment (combined endoscopic group).Amount of bleeding,operation time,hospital stay as well as expense,and rate of urethral stricture and erectile dysfunction (ED) in treatment of anterior and posterior urethral injury were compared respectively.Curativeeffect and merits and faults of each treatment were observed.Results Anterior endoscopic group achieved less bleeding [(10 ± 5) ml∶ (100 ± 20) ml,P ＜ 0.05],shorter operation time and hospital stay [(15 ± 6) min∶ (40 ± 15) min,(14.2 ± 1.8) min∶ (28.5 ± 1.5) min respectively,P ＜ 0.05],lower hospital expense and urethral stricture rate[(4 715.42 ± 225.43) RMB∶ (6 886.46 ± 246.78) RMB,39％ ∶ 63％ respectively,P ＜ 0.05] as compared with repair group,but there was no statistical difference in ED rate between the two groups.Whereas in anastomosis group,the most bleeding [(200 ± 30) ml],longest operation time [(60 ± 20) minutes] and hospital stay [(28.7 ± 2.3) days],and highest hospital expense [(6 964.27 ± 275.69) RMB] and urethral stricture rate (95 ％) were detected (P ＜ 0.05).Posterior endoscopic group presented less bleeding [(15 ± 6) ml∶ (50 ± 12) ml,P ＜ 0.05] and shorter operation time [(21.4 ± 1.7) min∶ (21.2 ± 1.5) min,P ＜ 0.05] as compared with combined endoscopic group,but there were no statistical differences in hospital stay as well as expense and urethral stricture rate between the two groups.Moreover,ED rate was not statistically different among anastomosis group,posterior endoscopic group and combined endoscopic group.Conclusions Endoscopic surgery is superior to traditional surgery in terms of blood loss,operation time,hospital stay,and hospital cost.Besides,urethral stricture and ED rates are closely related to the location and severity of injury.

Gastric precancerous lesion refers to epithelial dysplasia(atypical hyperplasia or intraepithelial neoplasias),which is associated with increased risk of gastric cancer.It happens to be controlled by multiple factors and/or polygene such as the H.pylori infection,diet and environment which play an important role in the development of gastric precancerous lesions.This article describes the pathogenesis of gastric precancerous lesions as many scholars have studied some of it.

Objective To investigate prognostic factors for gastric cancer patients with liver cirrhosis.Methods The clinicopathological data of 52 gastric caner patients with liver cirrhosis operated on between March 1994 and March 2006 were analyzed retrospectively and the prognostic factors were evaluated.Significant factors were then entered into a Cox regression analysis.Results The postoperative 1-3- and 5- year survival rates for these 52 patients followed up were 78％,44％ and 33％.Univariate analysis revealed that age,Borrmann type,histology timue typing,tumor size,pTNM stage,Child-pugh grade,postoperative complications,ascites,and albumin level were statistical significance for survival rate (P ＜ 0.05 ).Multivariate analysis demonstrated that pTNM stage,Child-pugh grade,ascites were independent prognostic factors affecting prognosis( P ＜ 0.05 ).The risk of Child-pugh grade is 3.005,the risk of pTNM is 1.594.Conclusions Compared with pathological disease stage of the gastric cancer,liver function affects more on the prognosis of cirrhotic gastric cancer patients undergoing gastrectomy.In Child-pugh grade B or C cases,postoperative liver dysfunction was the main concern.While those of Child-pugh grade A should undergo standard D2 gastrectomy.

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.

Objective 　To investigate the anatomic characteristics of optic canal in chinese adults. Methods　Twenty chinese cadaveric speciments fixed in formalin of chinese patients without intracranial and intraorbital disease. We measured the width and height of the intracranial opening and the intraorbital opening of the optic canal of all cases. The length of roof, floor, medial and lateral wall of the optic canal, and the width, the height of the middle protion were also measured after unroofing the canal with high-speed drilling. The degree of pneumatization of ethmoidal and sphenoidal sinuses was recorded. Results　The intracranial opening of the optic canal was a horizontal oval shape. The width of it was (5.05±0.42) mm and the height was (4.61±0.27) mm. The length of optic roof, optic floor, medial wall and lateral wall of the optic canal was (9.67±1.51) mm, (5.41±0.84) mm, (9.58±0.72) mm and (9.26±0.66) mm, respectively. The intraorbital opening of the optic canal was a vertical oval shape, the height and width of it was (5.30±0.64) mm and (5.62±0.83) mm respectively. Conclusions　The wall of the optic canal is thinner and there is a narrow portion in the middle of it. Depending on the degree of the pneumatization of sphenoidal and ethmoidal sinus, three types were divided into: 1. reversal U shape, 2. C shape, 3. D shape. The dura fold of the optic canal is long and its edge is sharp.

The paper expounds the humane landscape condition and resource of Zhejiang TCM ,puts emphasis on the evaluation of hu-mane connotation of Hangzhou Huqing Yutang, Yiwu Danxi Lingyuan and Lanxi Zhuge Village Dajingtang pharmaceutical mu-eums, also proposes detailed plan of Hangzhou TCM humane landscape construction.

Objective To evaluate laparoscopy assisted radio frequency ablation (LRFA) and percutaneous radiofrequency ablation ( PRFA ) for the treatment of hepatocellular carcinoma ( HCC ).Methods A total of 525 HCC patients were enrolled,including LRFA group of 78 cases with 106 tumor nodules,and PRFA group of 447 cases with 565 tumor nodules.Results ( 1 ) In LRFA group complete ablation rate was 97.17％ (103/106); in LRFA group complete ablation rate was 93.09％ (526/565)(x2 =2.523,P =0.112).(2)The 1,3,5 year overall survival rate was 96.15％,55.12％ and 38.46％in LRFA group and 93.73％,48.54％ and 31.54％ in PRFA group respectively ( x2 =0.699,1.151,1.447 ; P =0.403,0.283,0.229 ).The 1,3,5 year disease-free survival rate was 94.87％,43.58％ and 28.21％ in LRFA group and 93.73％,48.54％ and 31.54％ in PRFA group respectively (x2 =0.915,0.303,0.174; P=0.339,0.582,0.676).The average disease-free survival time was 22.25 months in LRFA group and 21.53 months in PRFA group respectively.(3)The serious complications was 0％ (0/78)in LRFA group and 1.34％ ( 6/447 ) in PRFA group respectively.( 4 ) Recurrence rate was 23.07％(18/78) in LRFA group,and 34.89％ (156/447) in PRFA group ( x2 =4.189,P =0.041 ).Conclusions The therapeutical effect of LRFA equals that of PRFA,while enjoying lower recurrence rate,no serious complications and higher treatment safety.

Stem cells are characterized by the ability to renew themselves and differentiate into a di-verse range of specialized cell types.Bmi1 gene has been determined to play critical roles in the self-renewal of stem cells.Many of the tumor originated in stem cells.Enhanced self-renewal capability in stem/progenitor cells changes its biological characteristic and drives tumor initiation